The Impairment Argument's Coup de Grâce.

According to Hendricks Impairment Argument (IA), abortion is immoral because it impairs the fetus. Here, I argue it is not sufficient to show merely that abortion impairs, Hendricks must show that it harms the fetus. If the fetus is not numerically identical to the person it will become, then it isn't harmed by an abortion.

A pan-tumor review of the role of poly(adenosine diphosphate ribose) polymerase inhibitors.

Poly(adenosine diphosphate ribose) polymerase (PARP) inhibitors, such as olaparib, talazoparib, rucaparib, and niraparib, comprise a therapeutic class that targets PARP proteins involved in DNA repair. Cancer cells with homologous recombination repair defects, particularly BRCA alterations, display enhanced sensitivity to these agents because of synthetic lethality induced by PARP inhibitors. These agents have significantly improved survival outcomes across various malignancies, initially gaining regulatory approval in ovarian cancer and subsequently in breast, pancreatic, and prostate cancers in different indications.

Role of data-driven regional growth model in shaping brain folding patterns.

The surface morphology of the developing mammalian brain is crucial for understanding brain function and dysfunction. Computational modeling offers valuable insights into the underlying mechanisms for early brain folding. Recent findings indicate significant regional variations in brain tissue growth, while the role of these variations in cortical development remains unclear.

Pediatric Scleral Lenses: 21-Year Retrospective Review.

Purpose: Retrospective study to review scleral lens outcomes in the pediatric population over a 21-year period, at a single clinical center.

Results: A total of 209 pediatric eyes (108 males and 101 females), distributed between 97 right and 112 left eyes, of which 147 eyes had ocular surface disease and 62 eyes had irregular cornea/refractive conditions, were treated with scleral lenses over a 21-year period. The mean age at the time of treatment initiation was 10.

Robot-Assisted Resection of Tricuspid Valve Papillary Fibroelastoma.

We report 3 cases of papillary fibroelastoma of the tricuspid valve. Two of them manifested with atypical symptoms of chest pressure and chest pain. Robot-assisted resection was performed to remove the mass while preserving the native valve.

Endoluminal Functional Imaging Demonstrates Need for Myotomy During Epiphrenic Diverticulectomy.

Epiphrenic diverticulum develops when elevated esophageal intraluminal pressure causes herniation of the mucosa and submucosa through an area of weakness in the muscularis layer. Treatment must address both the diverticulum and the underlying esophageal dysmotility. The endoluminal functional lumen imaging probe allows measurement of the lower esophageal sphincter pressures to achieve the ideal lower esophageal sphincter distensibility that prevents postoperative gastroesophageal reflux disease as well as diverticulum recurrence.

Do Cultural Adaptations Matter? Comparing Caregiver Training in Different Language for Latino Caregivers of Autistic Children: A Telehealth-Based Evaluation.

Culturally and linguistically diverse (CLD) families of autistic children face unique challenges in accessing services that are appropriate for their cultures and languages. The purpose of the current study was to evaluate the impact of training language on caregiver skill acquisition. Using behavioral skills training (BST) through telehealth, three Latino caregivers whose first language is Spanish were taught to implement two different behavioral protocols with their autistic children.

Beyond Trial Counts: Considerations for Measuring Play and Engagement During Early Intervention for Autistic Children.

Play is critical to child development. In early childhood, object play evolves from exploratory behavior to complex symbolic play. Engagement during play, particularly joint engagement, is essential for learning and social interaction.

Patient Challenges in Utilization of Methadone to Treat Opioid Use Disorder and Perspectives on a Solution for Improved Security and Convenience in Take-home Dosing.

Background: Methadone is commonly utilized to treat opioid use disorder (OUD). Requirements to visit an opioid treatment provider (OTP) clinic for methadone treatment limits access to treatment, impacts quality of life, and reduces OUD treatment program retention. The Computerized Oral Prescription Administration (COPA) system is a dual-biometric dispensing device for take-home dosing that could reduce the impacts of methadone administration on patients and clinic staff.

Seasonal Variation in Home Range Sizes and Daily Distance to Ephemeral Surface Water for African Savannah Elephant () in Eastern Okavango Panhandle, Northern Botswana.

African elephants () are megaherbivores of the African savannas requiring extensive ranges that can provide critical resources for their survival and reproduction at different spatiotemporal scales. We studied seasonal differences in home range sizes and daily distance to the nearest surface water sources by five male and 10 female African elephants in the eastern Okavango Panhandle in northern Botswana between 2014 and 2017. We hypothesized that (i) elephant home ranges would be larger in the wet than in the dry season (because critical resources tend to be less localized in the wet than in the dry season), (ii) the daily distance of the elephants to the nearest ephemeral surface water sources would be larger in the dry than in the wet season because many of the ephemeral water sources would be dry in the dry season and elephants would start moving towards permanent water sources such as rivers, and lastly (iii) that the differences in elephant home ranges and daily distance to water would differ between sexes.

Clinical Variant of Serpentine Supravenous Hyperpigmentation Following Subcutaneous Bortezomib Injection.

Introduction: Bortezomib is a reversible proteasome inhibitor that is a first-line chemotherapeutic agent for multiple myeloma. Bortezomib can be administered intravenously or subcutaneously with similar efficacy. Subcutaneous administration has fewer side effects.

Assessment of the European Hernia Society Classification of Ventral Hernias and Clinical Outcomes.

Background: Ventral hernias are a common but heterogeneous disease. Communication among key stakeholders (eg, patients, clinicians, administrators, payers, and researchers) can be augmented by a widely utilized classification system. The European Hernia Society (EHS) developed an expert-opinion-based hernia classification system organized by hernia type (primary versus incisional) and size.

An Unexpected Outcome of an Ischemic Stroke on the Reward Pathways in the Human Brain.

Background: Addiction affects millions of people, often resulting from a complex interplay between genetic and environmental factors, and is frequently linked to mental health disorders. Many experts agree there is no cure for addiction, but there are effective treatments available. Many patients continue to succumb to addiction despite treatment.

Gender Bias in Letters of Recommendation for Cardiothoracic Surgery Applicants.

Background: Bias in letters of recommendation may have an impact on assessment of the cardiothoracic surgical applicant. Letters written for fellowship candidates might differ on the basis of the applicant's gender, although prior investigations have not explored this population. We aimed to evaluate gender differences in letters of recommendation written for cardiothoracic surgery applicants.

ChatGPT vs Expert-Guided Care Pathways for Postesophagectomy Symptom Management.

Background: The objective of this study was to compare generative artificial intelligence-initiated care pathways, using ChatGPT, with expert-guided consensus-initiated care pathways from AskMayoExpert (AME) for symptom management of esophageal cancer patients after esophagectomy.

Methods: A formal protocol for development of 9 AME care pathways was followed for specific patient-identified domains after esophagectomy for esophageal cancer. Domain scores were measured and assessed through the Upper Digestive Disease tool.

Occluder Device Removal and Total Septation of "Swiss-Cheese" Ventricular Septal Defects.

"Swiss-cheese" ventricular septal defects present complex treatment challenges. Despite difficult defect visualization and closure, complete septation is the treatment of choice. We present the case of a 2-year-old with residual apical "Swiss-cheese" ventricular septal defects after failed percutaneous device closure with 2 occluder devices.

Pulmonary Atresia Intact Ventricular Septum With Anomalous Left Coronary Artery From Pulmonary Artery.

A patient with known pulmonary atresia and intact ventricular septum and ductal stent presented with low cardiac output and arrythmia. Intraoperatively, the patient was found to have an anomalous left coronary artery arising from the pulmonary artery. After reimplantation of the left coronary artery to the aortic root and placement of a central shunt, the patient progressed well and was discharged home.

Endoluminal Wound Vacuum Therapy: A Paradigm Shift in Managing Esophageal Bronchial Fistula.

Esophageal bronchial fistula after Ivor Lewis esophagectomy is a challenging complication. Surgical treatment is definitive, but it carries high morbidity and mortality, whereas esophageal stents have been shown to be temporary measures. We highlight the case of a patient who was treated with endoluminal wound vacuum therapy.

Long-Term Outcomes With Expanded Polytetrafluoroethylene Valved Conduits in Pediatric Patients.

Background: The expanded polytetrafluoroethylene (ePTFE) valved conduit (VC) has been reported for pulmonary valve replacement (PVR). The purpose of this study was to review long-term outcomes of our trileaflet ePTFE VC.

Methods: This multicenter study was performed with institutional review board approval from each institution.

Cardiomegaly Status After Open Repair of an Arch Aneurysm.

This report describes a patient with a thoracic aortic aneurysm who presented with chest pain and dyspnea. Preoperative studies revealed a massive cardiomediastinal silhouette. Within hours after the operation, a profound reduction in cardiomegaly was observed.

Substance Use and Outcomes of Left-Sided Valve Replacement in Patients With Infective Endocarditis.

Background: Rising rates of substance use (SU) have resulted in an increasing need for left-sided valve surgery for SU-associated infective endocarditis (SU-IE). We compared outcomes, readmissions, and costs between IE patients with and without SU-IE in a national cohort.

Methods: Using the Nationwide Readmissions Database (2016-2018), we identified 10,098 patients with infective endocarditis (IE) who underwent isolated aortic or mitral valve replacement.

Outcomes of Full and Partial Cardiac Autotransplantation for Complex Left-Sided Heart Tumors.

Background: Complex or malignant left-sided heart tumors present a challenge for resection and reconstruction. Cardiac autotransplantation was developed to address this but is a complex technique. Partial autotransplantation was developed to simplify the procedure.